Climate change adaptation in conflict-affected countries: A systematic assessment of evidence.

People affected by conflict are particularly vulnerable to climate shocks and climate change, yet little is known about climate change adaptation in fragile contexts. While climate events are one of the many contributing drivers of conflict, feedback from conflict increases vulnerability, thereby creating conditions for a vicious cycle of conflict. In this study, we carry out a systematic review of peer-reviewed literature, taking from the Global Adaptation Mapping Initiative (GAMI) dataset to documenting climate change adaptation occurring in 15 conflict-affected countries and compare the findings with records of climate adaptation finance flows and climate-related disasters in each country. Academic literature is sparse for most conflict-affected countries, and available studies tend to have a narrow focus, particularly on agriculture-related adaptation in rural contexts and adaptation by low-income actors. In contrast, multilateral and bilateral funding for climate change adaptation addresses a greater diversity of adaptation needs, including water systems, humanitarian programming, and urban areas. Even among the conflict-affected countries selected, we find disparity, with several countries being the focus of substantial research and funding, and others seeing little to none. Results indicate that people in conflict-affected contexts are adapting to climate change, but there is a pressing need for diverse scholarship across various sectors that documents a broader range of adaptation types and their results.

Rapid detection of urinary tract infections using isotachophoresis and molecular beacons.

We present a novel assay for rapid detection and identification of bacterial urinary tract infections using isotachophoresis (ITP) and molecular beacons. We applied on-chip ITP to extract and focus 16S rRNA directly from bacterial lysate and used molecular beacons to achieve detection of bacteria specific sequences. We demonstrated detection of E. coli in bacteria cultures as well as in patient urine samples in the clinically relevant range 1E6-1E8 cfu/mL. For bacterial cultures we further demonstrate quantification in this range. The assay requires minimal sample preparation (a single centrifugation and dilution), and can be completed, from beginning of lysing to detection, in under 15 min. We believe that the principles presented here can be used for design of other rapid diagnostics or detection methods for pathogenic diseases.

Interaction of nonsteroidal anti-inflammatory drugs (NSAID) with Helicobacter pylori in the stomach of humans and experimental animals.

Helicobacter pylori (H. pylori) and non-steroidal anti-inflammatory drugs (NSAID) are major pathogenic factors in peptic ulcer disease but whether these two factors exert synergistic or antagonistic action on the gastric mucosa has been a subject of controversy. The classic concept states that there is an increased ulcer occurrence and bleeding in patients with both H. pylori infection and NSAID use. However, the question whether the H. pylori eradication therapy in NSAID users reduces the occurrence of peptic ulcer has not been fully addressed. Studies on secondary prevention of NSAID-associated ulcers in H. pylori patients have indicated that H. pylori eradication results in impaired ulcer healing with an effect on the rate of peptic ulcer occurrence. On the other hand, the treatment of H. pylori in patients with no prior history of chronic NSAID therapy has been shown to decrease the risk of peptic ulcer. Studies in experimental animals revealed for instance, that the H. pylori infection augments the gastric mucosal damage induced by NSAID in Mongolian gerbils. In rats with preexisting chromic gastric ulcers, H. pylori infection attenuated significantly the aspirin-induced inhibition of ulcer healing and accompanying fall in the gastric blood flow at the margin of these ulcers, suggesting negative interaction between aspirin and H. pylori on ulcerogenesis. Accumulated evidence in humans and animals shows that both aspirin and H. pylori upregulate the expression of cyclooxygenase (COX)-2 both at mRNA and protein levels at the ulcer margin, but failed to influence significantly that of COX-1. It was, therefore, proposed that H. pylori may in fact, antagonize, aspirin-induced delay of ulcer healing due to suppression of acid secretion by the enhancement in PGE(2) possibly derived from COX-2 expression and activity and to the overexpression of growth factors such as TGF alpha and VEGF. The present review summarizes and further addresses the issue of the interaction between these two major ulcer risk factors determined in the stomach of humans and experimental animals.

Significance of salicylate intolerance in diseases of the lower gastrointestinal tract.

Salicylate intolerance is defined as a nonspecific antigen-induced pseudo-allergic hypersensitivity reaction which can occur upon contact of an organism with salicylic acid, its derivatives or other related organic or inorganic acids of similar chemical structure. Since the effects of nonsteroidal anti-inflammatory drugs (NSAID) intolerance are by no means always severe or life-endangering but may just as well present as oligosymptomatic or local disorders (e.g. abdominal pain, diarrhea, we decided to evaluate the characteristics of patients with salicylate intolerance on the basis of gastroenterological case material of Medical Department I of Erlangen University. On the basis of the findings from the Erlangen interdisciplinary data register of chronic inflammatory gastrointestinal disease, the signs and symptoms of NSAID intolerance were found to constitute a diagnosis of great practical import to clinical medicine (allergology, dermatology, immunology, other disorders etc.) including gastroenterology. For approx. 2-7% of all patients with inflammatory bowel syndrome and food allergies this poses a new diagnostic and therapeutic challenge which may concern physicians from any of the disciplines involved. When presented with patients with chronic active disease who are suffering from these symptoms one should, therefore, in future give greater thought to the possibility of salicylate intolerance, all the more as there are meaningful dietetic, diagnostic and therapeutic options available for these persons.

A ferrocenyl-substituted pseudotitanocene complex

The title compound, (eta(5)-cyclopentadienyl)[(1,2,3,4, 5-eta)-4-ferrocenyl-1,2,5,6-tetrakis(trimethylsilyl)cyclohexa-2, 4-dien-1-yl]titanium(II), [TiFe(C(5)H(5))(2)(C(23)H(42)Si(4))] or [Tieta(5)-C(6)H(2)Fe(eta(5)-C(5)H(4))(eta(5)-C(5)H(5))Si(CH(3))(3 )(4)(eta(5)-C(5)H(5))], possesses two directly linked metallocene units that subtend an angle of 52.9 (1) degrees (defined by the least-squares planes of the directly connected pi-ligands) associated with the steric requirements of the bulky trimethylsilyl substituents. The cyclohexadienyl ligand adopts an envelope conformation; the perpendicular distance of its eta(5)-plane to the Ti atom is 1.512 (1) A.

Reduction of bis

The reduction of symmetric, fully-substituted titanocene dichlorides bearing two pendant omega-alkenyl groups, [TiCl2(eta5-C5Me4R)2], R = CH(Me)CH= CH2 (1a). (CH2)2CH=CH2 (1b) and (CH2)3CH=CH2 (1c), by magnesium in tetrahydrofuran affords bis(cyclopentadienyl)titanacyclopentanes [Ti(IV)[eta1:eta1: eta5:eta5-C5Me4CH(Me)CH(Ti)CH2CH(CH2(Ti))CH(Me)C5Me4]] (2a), [Ti(IV)[eta1:eta1:eta5: eta5-C5Me4(CH2)2CH(Ti)(CH2)2CH(Ti)(CH2)2C5Me4]] (2b) and [Ti(IV)[eta1:eta1:eta5:eta5-C5Me4(CH2)2CH(Ti)CH(Me)CH(Me)CH(Ti)(CH2)2C5Me4]](2c), respectively, as the products of oxidative coupling of the double bonds across a titanocene intermediate. For the case of complex 1c, a product of a double bond isomerisation is obtained owing to a preferred formation of five-membered titanacycles. The reaction of the titanacyclopentanes with PbCl2 recovers starting materials 1a from 2a and 1b from 2b, but complex 2c affords, under the same conditions, an isomer of 1c with a shifted carbon - carbon double bond, [TiCl[eta5-C5Me4(CH2CH2CH=CHMe)]2] (1c'). The titanacycles 2a-c can be opened by HCl to give ansa-titanocene dichlorides ansa-[[eta5:eta5-C5Me4CH(Me)CH2CH2CH(Me)CH(Me)C5Me4]TiCl2] (3a), ansa-[[eta5:eta5-C5Me4(CH2)8C5Me4]TiCl2] (3b), along with a minor product ansa-[[eta5:eta5-C5Me4CH2CH=CH(CH2)5C5Me4]TiCl2] (3b'), and ansa-[[eta5:eta5-CsMe4(CH2)3CH(Me)CH(Me)CH=CHCH2C5Me4]TiCl2] (3c), respectively, with the bridging aliphatic chain consisting of five (3a) and eight (3b, 3b' and 3c) carbon atoms. The course of the acidolysis changes with the nature of the pendant group; while the cyclopentadienyl ring-linking carbon chains in 3a and 3b are fully saturated, compounds 3c and 3b' contain one asymetrically placed carbon-carbon double bond, which evidently arises from the beta-hydrogen elimination that follows the HCl addition.

Loss of Rhb1, a Rheb-related GTPase in fission yeast, causes growth arrest with a terminal phenotype similar to that caused by nitrogen starvation.

The Rheb GTPase is most similar in primary sequence to the Ras, Rap, R-Ras, and Ral GTPases, which regulate cell growth and differentiation in many cell types. A likely fission yeast homologue of mammalian Rheb, which we designated Rhb1, was identified by genome sequencing. Our investigation of rhb1 showed that rhb1(-) cells arrested cell growth and division with a terminal phenotype similar to that of nitrogen-starved cells. In particular, cells depleted of Rhb1 arrested as small, round cells with 1N DNA content, arrested more quickly in low-nitrogen medium, and induced expression of fnx1 and mei2 mRNA, two mRNAs that were normally induced by nitrogen starvation. Since mammalian Rheb binds and may regulate Raf-1, a Ras effector, we tested for functional overlap between Ras1 and Rhb1 in fission yeast. This analysis showed that Ras1 overexpression did not suppress rhb1(-) mutant phenotypes, Rhb1 overexpression did not suppress ras1(-) mutant phenotypes, and ras1(-) rhb1(-) double mutants had phenotypes equal to the sum of the corresponding single-mutant phenotypes. Hence, there is no evidence for overlapping functions between Ras1 and Rhb1. On the basis of this study, we hypothesize that Rhb1 negatively regulates entry into stationary phase when extracellular nitrogen levels are adequate for growth. If this hypothesis is correct, then Rhb1 and Ras1 regulate alternative responses to limiting nutrients.

Medium-chain triglycerides inhibit growth of Malassezia: implications for prevention of systemic infection.

OBJECTIVE: Lipophilic Malassezia species may induce catheter-associated sepsis in newborns and immunocompromised patients receiving parenteral lipids. Therefore, we tested whether M. furfur and six other Malassezia species can use commercially available infusions as a lipid source. DESIGN: Prospective in vitro study. SETTING: Research laboratory in a university hospital. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: With the exception of M. restricta, all Malassezia species grow on lipid infusions. There are no substantial differences among the different brands. The most rapid growth is shown by M. furfur, which grows better on agar containing a 20% rather than a 10% lipid infusion. Growth of M. furdur and M. sympodialis can be reduced by infusions containing medium-chain triglycerides. Incubated in triglycerides, M. furfur is strongly suppressed by 50% medium-chain triglycerides and M. sympodialis by 8% medium-chain triglycerides. When medium-chain free fatty acids are added to triglycerides, both species can be suppressed by about 1% free fatty acids. CONCLUSION: Medium-chain triglycerides and medium-chain free fatty acids are toxic for Malassezia species. Commercially available infusions containing medium-chain triglycerides might be used to prevent systemic Malassezia infections.

ras1 and pat1 alleles interact to quantitatively and qualitatively alter conjugation in fission yeast.

To identify novel components of ras1+ signalling in Schizosaccharomyces pombe, extragenic suppressors of the mating defect of ras1 effector mutants were isolated. A novel allele of pat1, pat1-e1, was isolated that increases the mating of ras1-D43E mutants to near wild-type levels but does not suppress the mating defect of ras1-I41M, ras1-Y37F, or ras1-Y45I mutants. This allele-specific suppression is not a characteristic of all pat1 alleles since pat1-3 and pat1-114 partially and equally suppress ras1-D43E and ras1-I41M mutants. Analysis of mating cultures showed that ras1-D43E and pat1-e1 interact to qualitatively alter the mating response. While pat1-e1 ras1-D43E cells were delayed in agglutination, cell-cycle delay, and mat1-Pm transcription, they induce mat1-Mc at the same time and mate more rapidly than other mating cultures. These results suggest that pheromone signalling, but not nutritional signalling, is delayed in pat1-e1 ras1-D43E cells. We hypothesize that this delay causes an elevated pheromone response and thus suppression of the mating defect of the ras1-D43E mutant by pat1-e1.

A novel suppressor of ras1 in fission yeast, byr4, is a dosage-dependent inhibitor of cytokinesis.

A novel gene, designated byr4, was identified in Schizosaccharomyces pombe that affects the mitotic cell cycle and shows genetic interactions with the ras1 signaling pathways. Null alleles of byr4 cause cell cycle arrest in late mitosis and permit multiple rounds of septation. The multiple septa typically divide two nuclei, but the nuclei frequently do not stain equally with 4',6-diamidino-2-phenylindole (DAPI), suggesting that byr4 is required for proper karyokinesis. Overexpression of byr4 inhibits cytokinesis, but cell cycle progression continues leading to multinucleate cells. When byr4 is overexpressed, the early steps in the cytokinesis pathway, including formation of the medial F-actin ring, occur normally; however, the later steps in the pathway, including contraction of the F-actin ring, septation, and rearrangement of the medial F-actin following mitosis, rarely occur, byr4 shows two genetic interactions with ras1. The inhibition of cytokinesis by byr4 overexpression was exacerbated by null alleles of ras1 and scd1, suggesting a link between pathways needed for cell polarity and cytokinesis. Overexpression of byr4 also partially bypasses the need for ras1 for sporulation. The electrophoretic mobility of the byr4 protein varied in response to mutants that perturb cytokinesis and karyokinesis, suggesting interactions between byr4 and these gene products. A more rapidly migrating byr4 protein was found in cells with mutations in cdc16, which undergo repeated septation, and in cdc15, which fail to form a medial F-actin ring in mitosis. A slower migrating byr4 protein was found in cells with a mutation in the beta-tubulin gene, which arrests cells at the metaphase-anaphase transition.

Phase I/II trial of dexverapamil, epirubicin and granulocyte/macrophage-colony-stimulating factor in patients with advanced pancreatic adenocarcinoma.

A group of 28 previously untreated patients with locally advanced or metastatic adenocarcinoma of the pancreas were entered in this phase I/II study. Treatment consisted of oral dexverapamil 1000-1200 mg/day for 3 days, epirubicin given as an intravenous bolus injection on day 2 with a starting dose of 90 mg/m2, and 400 micrograms granulocyte/macrophage-colony-stimulating factor (GM-CSF) administered subcutaneously from day 5 through 14. Epirubicin dose escalation levels were 90, 105, 120 and 135 mg/m2. Consecutive cohorts of 4-8 patients were planned at each dose level. Treatment cycles were repeated every 3 weeks. Haematological toxicity, specifically granulocytopenia constituted the dose-limiting toxicity with a maximum tolerated dose of 120 mg/m2 for epirubicin. Despite routine supportive therapy with GM-CSF, 4, 2, and 5 patients experienced grade 4 granulocytopenia during their first two treatment courses at levels of 105, 120, and 135 mg/m2 respectively. Non-haematological toxicity was uncommon, generally modest, and did not demonstrate a clear relationship with the anthracycline dose. Dexverapamil-related cardiovascular symptoms occurred frequently, but they never resulted in serious toxicity requiring active medical intervention or permanent discontinuation of therapy. Of the 28 patients, 9 achieved partial reponses to this therapy. The recommended dose of epirubicin for this regimen with dexverapamil and GM-CSF is 120 mg/m2 every 3 weeks. Therapeutic results suggest this regimen to be an effective and tolerable treatment strategy in pancreatic cancer, which should be evaluated further.

Post-transcriptional action of ACTH in the control of P450c17 expression in rabbit adrenal glands.

Stimulation of transcription of the CYP17 gene by ACTH has been demonstrated previously by others using cultures of adrenal tissue from several species. In the present investigations we have demonstrated from measurements in pooled rabbit adrenal glands that after 4 or 6 days of ACTH injections no difference in amounts of CYP17 mRNA per microgram of total adrenal RNA was observed between ACTH and control animals. While the total amount of CYP17 mRNA per adrenal increased 1.4- to 1.7-fold over the injected and non-injected controls due to an increase in total RNA in the ACTH-stimulated adrenals, Western analysis of adrenal microsomal protein demonstrated that the amount of adrenal P450c17 protein, the product of the CYP17 gene, increased over 50-fold. The data show that ACTH is acting at both transcriptional and post-transcriptional loci to increase the amount of rabbit adrenal P450c17 and that the greater effect is post-transcriptional.

Genetic transformation of the Lyme disease agent Borrelia burgdorferi with coumarin-resistant gyrB.

No useful method to genetically manipulate Borrelia burgdorferi, the causative agent of Lyme disease, has been developed previously. We have used resistance to the coumarin antibiotic coumermycin A1, an inhibitor of DNA gyrase, as a genetic marker to monitor the transformation of B. burgdorferi by electroporation. Introduction of site-directed mutations into the gyrB gene demonstrated that transformation was successful, provided evidence that homologous recombination occurs on the chromosome, and established that mutations at Arg-133 of DNA gyrase B confer coumermycin A1 resistance in B. burgdorferi. The coumermycin A1-resistant gyrB marker and genetic transformation can now be applied toward dissecting the physiology and pathogenesis of the Lyme disease agent on a molecular genetic level.

[Balloon dilatation of benign esophageal stenoses]. / Ballondilatation von benignen Osophagusstenosen.

Benign stenoses of the oesophagus have been conventionally treated by endoscopic bougienage and were operated on in case of failure. Now that balloon catheters with large balloon diameters are available, interventional radiological dilatation of enteric strictures can be easily performed. In case of eccentric high-grade stenosis with or without blind loop, stenosis is often easier to manage and associated with less risk with an angiographic guide wire and catheter than by endoscopy. 53.3% of the patients were referred to balloon dilatation after failed endoscopic bougienage. The indications for balloon dilatation were anastomotic stenosis (66.2%), peptic stenosis (16.9%), achalasia (7%), pylorospasm (5.6%) and stenosis due to pemphigus vulgaris, acid ingestion and (in one case) a Schatzki ring. The complication rate was low at 1%. The experience collected with 297 dilatations in 71 patients with benign oesophageal stenosis, is reported.

[Repeat mass screening for fecal occult blood for the diagnosis of colorectal neoplasms in a rural district. Results of an informational campaign]. / Wiederholte Massenscreeninguntersuchung auf okkultes Blut im Stuhl zur Erfassung kolorektaler Neoplasien in einem ländlichen Bezirk. Ergebnisse einer Informationskampagne.

In 1987/88 and 1988/89 we tested the population (aged greater than or equal to 40) of the district of Oberpullendorf in 2 series for faecal occult blood by means of the Hemdetect Test. In the first test series the test was offered to 18,233 persons and 8235 (45%) persons completed the test; 187 (2.3%) were positive. In the second series 6512 (36%) out of 18,241 completed the test and 472 (7.2%) persons were positive. The persons with positive results were examined by colonoscopy, gastroscopy, and abdominal sonography, in combination with routine investigations. Secondary compliance in these investigations was 92%. The screening method revealed 34 colorectal cancers with the favourable pathological staging: Dukes A 18 (53%), Dukes B 6 (18%), Dukes C 10 (29%), Dukes D 0. 11 polyps showing carcinoma in situ and 174 polyps (70% of which were adenomas) in 124 patients were treated by colonoscopy. In the meantime we have detected 14 "interval" cancers among people with a false negative test result, also at a favourable staging: Dukes A 6 (43%), Dukes B 4 (29%), Dukes C 4 (29%), Dukes D 0. In the non-responders we found 30 colorectal cancers at a much worse staging: Dukes A 7 (23%), Dukes B 10 (33%), Dukes C 8 (27%), and Dukes D 5 (17%). Screening for faecal occult blood in combination with the necessary investigations of the positive persons by colonoscopy is able to detect symptomless colorectal cancers at a less advanced pathological stage and enables the treatment of precancerous adenomatous polyps. An improvement in cumulative sensitivity is expected on annual repetition of screening for faecal occult blood.

[Radiological contribution to skeletal changes in systemic mastocytosis. Urticaria pigmentosa]. / Radiologischer Beitrag zu den Skelettveränderungen der "systemischen Mastozytose"--Urticaria pigmentosa.

Three patients are demonstrated suffering from systemic mastocytosis with skin and skeletal involvement. History, clinical and radiological results are reported. After a brief analysis of the pathogenetic mechanism, the radiological findings on the skeletal system in systemic mastocytosis are discussed. Finally, roentgenological differential diagnosis of the osseous lesions is explained.

[Treatment of Amanita phalloides poisoning with silybin in combination with penicillin and cortisone]. / Therapie der Knollenblätterpilzvergiftung mit Silibinin in Kombination mit Penicillin und Cortison.

A report is presented of Amanita phalloides poisoning in a family of 3 members admitted with acute gastrointestinal symptoms after eating a meal of various self-picked mushrooms. A latent period of 11 hours preceded the onset of symptoms, a typical feature of this form of poisoning. There was an enormous increase in liver-specific enzymes in two of the cases. The clinical picture was markedly mitigated by the early initiation of silybin therapy, in combination with penicillin and cortisone. The patients made a rapid symptomatic recovery and the liver parameters were sufficiently improved by the 12th day so that the patients could be discharged.

Kwashiorkor-like zinc deficiency syndrome in anorexia nervosa.

This report deals with a 26-year-old white woman exhibiting signs of both Kwashiorkor (marasmus, pallor, hypopigmentation of hair and hepatomegaly) and acrodermatitis enteropathica (eczematous dermatitis predominantly on acral areas). Clinical and laboratory examinations excluded malabsorption syndrome and glucagonoma syndrome and revealed hypoproteinemia and marked zinc deficiency. Psychiatric examination disclosed anorexia nervosa. Substitution therapy led to rapid clearing of the skin lesions.